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Cited by 179Adolescent and Pediatric HealthcareChild and Adolescent HealthAdolescent Sexual and Reproductive Health

Male adolescent use of health care services: where are the boys?

Marcell, Arik V, Klein, Jonathan D, Fischer, Ismor, Allan, Marjorie J, Kokotailo, Patricia K·2002·Journal of Adolescent Health
DOI 10.1016/s1054-139x(01)00319-6
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Abstract

Purpose To describe patterns of health care use by adolescent males in the United States and clinical practice characteristics associated with their use of adolescent-specific programs.Methods Secondary analysis of three national data sets to determine health care use by male adolescents: the National Ambulatory Medical Care Survey [NAMCS (1994): pediatric, family physician, internal medicine, and obstetric/gynecologic outpatient visits]; National Hospital Ambulatory Medical Care Survey [NHAMCS (1994): outpatient department (OPD) and emergency department (ED) visits]; and Comprehensive Adolescent Health Services Survey [CAHSS (1995)]. Both NAMCS and NHAMCS are representative national probability samples. Total visit estimates by adolescents in 1994 to NAMCS sites were 387,076,630, to OPD sites were 6,511,244, and to ED sites were 13,161,824. For CAHSS, 468 programs (60% of eligible) participated. Data analyses were performed using two-tailed Student's t-tests and correlation testing.Results Older male adolescents, aged 16-20 years, account for a lower percentage of total visits to NAMCS sites combined compared to younger males, aged 11-15 years (15.8% vs. 25.1%, p <.001), mainly owing to a significant decline in visits to pediatricians (3.2% vs. 14.9%, p <.001), despite significant increases in female health care use during the same time period. Younger males were seen at similar rates compared to females at NAMCS, NHAMCS-OPD and NHAMCS-ED sites, but older males account for a significantly lower percentage of total visits than females to all NAMCS sites combined (15.8% vs. 34.7%, p <.001), the NHAMCS-ED (26.4% vs. 31.5%, p <.05), and the NHAMCS-OPD (15.0% vs. 41.2%, p =.001). Among specialized adolescent sites (CAHSS), 13-19-year-old males account for fewer visits than females to all programs types: schools (40% vs. 60%), hospitals (33% vs. 67%), and community/health departments (25% vs. 75%) (all p's < or =.001). Clinical practice characteristics correlated with having a greater proportion of male adolescent visit varied depending on the types of adolescent program examined.Conclusions Younger male adolescents make health care visits in relatively equal proportions to females at all NAMCS and NHAMCS locations and visits by older males are significantly reduced. Male adolescent visits are lower than females at all adolescent-specific programs; school-based clinics see the highest proportion of males. Greater understanding of male adolescents' transition between providers from adolescence to adulthood is needed to improve care to male adolescents who under-use health services.

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Authors
Marcell, A. V., Klein, J. D., Fischer, I., Allan, M. J., & Kokotailo, P. K.
Affiliations
  • University of California, San Francisco (US)
  • University of Rochester Medicine (US)
  • University of Wisconsin–Madison (US)
Corresponding author
Marcell, Arik V
ORCID
Venue
Journal of Adolescent Health
Publisher
Elsevier BV
Published
2002-01
Volume
30
Issue
1
Pages
35-43
ISSN
1054-139X (ISSN-L)
DOI
10.1016/s1054-139x(01)00319-6
OpenAlex
W2017589742
Cited by
179
References
45
Citations by year
2026: 2 · 2025: 2 · 2024: 2 · 2023: 6 · 2022: 5 · 2021: 8 · 2020: 9 · 2019: 6 · 2018: 9 · 2017: 9 · 2016: 13 · 2015: 7 · 2014: 9 · 2013: 12 · 2012: 14
FWCI
18.07
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Adolescent Health (publishedVersion)
  • PubMed (publishedVersion)
Funders
U.S. Public Health Service (2T71-MC-00003, 6T71-MC-00012-03R1)
Topics
  • Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
  • Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
  • Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
Keywords
adolescent boys, gender differences in health care use, adolescent health care, emergency department visits, outpatient visits, pediatric visits, health care access disparities
MeSH terms
Adolescent, Adult, Child, Female, Health Services Research, Humans, Male, Patient Acceptance of Health Care, United States, Adolescent Health Services, Age Distribution

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